Active NPI
Chris Black, LCSW-BACS
- Clinical Social Worker
- Bogalusa, LA
National Provider Identifier
1346605797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1417
- Practice address
- 5 Silvert Main PL
Bogalusa, LA 70427-4045 - Phone
- (985) 516-5275
- Fax
- (985) 400-5164
- NPI assigned
- Dec 29, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1417 | LA | Primary |
Addresses
Primary practice location
5 Silvert Main PL
Bogalusa, LA 70427-4045
Mailing address
5 Silvert Main PL
Bogalusa, LA 70427-4045
Phone (985) 516-5275
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1417 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451347200000",
"number": "1346605797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 SILVERT MAIN PL",
"city": "BOGALUSA",
"state": "LA",
"postal_code": "704274045",
"telephone_number": "985-516-5275",
"fax_number": "985-400-5164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 SILVERT MAIN PL",
"city": "BOGALUSA",
"state": "LA",
"postal_code": "704274045",
"telephone_number": "985-516-5275",
"fax_number": "985-400-5164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "CHRIS",
"credential": "LCSW-BACS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-29",
"last_updated": "2015-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "1417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bogalusa, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.